(Circulation. 2000;102:e9025.)
© 2000 American Heart Association, Inc.
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Stem Cells: The Answer or the Problem?
Perhaps no single issue in bioscience has created more controversy or a greater division than that of pluripotent stem cells. The National Institutes of Health (NIH) has published final guidelines for research involving pluripotent stem cells—almost 2 years after reports that the cells had been isolated were first published. (Shamblott M, et al, Derivation of pluripotent stem cells from cultured human primordial germ cells. Proc Natl Acad Sci U S A. 1998;95:13726–13731; Thomson J, et al, Embryonic stem cell lines derived from human blastocysts. Science. 1998;282:1145–1147). The guidelines, which took effect August 25, 2000, set out the rule under which the NIH will fund projects. However, those projects will involve only stem cells from frozen excess embryos created for fertility treatment and then not used.
The agency released a statement saying that it issued the guidelines to ensure that such research is "conducted in an ethical and legal manner... The NIH believes the potential medical benefits of human pluripotent stem cell technology is compelling and worthy of pursuit in accordance with appropriate ethical standards." However, in its August 24, 2000 issue, the publication Washington FAX said, "Opponents of such research almost certain will try to block it in Congress on the ground that isolating the cells from human embryos or fetal tissue destroys potential human life."
The promise of human pluripotent stem cells lies in the fact that they can give rise to different kinds of cells such as muscle, nerve, heart, and blood. Research with the cells may enable development of cells and tissues that can be transplanted into patients to treat many different diseases. Working with such cells will also give important clues to human development and to how such development can go wrong and result in diseases before and after birth.
A NIH Human Pluripotent Stem Cell Review group will be named soon to review requests for funding. More information is available on the Internet at www.nih.gov/news/stemcell/index.htm.
In a released response to the guidelines, Nobel Laureate Paul Berg, chair of the American Society of Cell Biology public policy committee, said, "The discovery of human pluripotent stem cells, the most basic building blocks of the human body, is a major scientific breakthrough, the full value of which cannot be overstated... Some have argued that this research is immoral, illegal and unnecessary. I respectfully disagree on all counts." He said that the guidelines are neither immoral nor illegal. He noted that arguments that adult stem cell research could be substituted for pluripotent stem cells ignore the fact that such research is in a very early stage and that its potential is unclear.
In a related development, the expert group on therapeutic cloning in the United Kingdom backed what it called "limited cloning", which would allow the use of early embryos to investigate the potential of new medical treatments, according to a news report in the September 2, 2000 issue of the British Medical Journal (BMJ 2000;321:530). The cloning could be performed when there was no other way of achieving the result, and embryos could be retained for no more than 14 days. All individuals whose eggs and sperm are used to create the embryos should give specific consent. Cloning to create a baby should remain illegal.
Stem cells are central to therapeutic cloning, according to the BMJ report. The UK panel said it was adopting the middle ground between those who consider an embryo a human being from the moment of creation and those who consider the early embryo a collection of cells.
The group’s report has been opposed by a variety of pro-life groups and churches. The full report can be found on the Internet at www.doh.gov.uk/cegc/.
NIH Celebrates a Decade of Women’s Health Research
The National Institutes of Health celebrated a decade of research dedicated to women’s health with a symposium on September 11, 2000—10 years and 1 day after the Office of Research on Women’s Health was established. Born out of women’s reaction to medical studies that concentrated on men, the office advises the NIH director and staff on matters relating to research on women’s health, strengthens and enhances the research in health and diseases that affect women, ensures that women are represented in biomedical research, and develops opportunities for the advancement of women in biomedical careers. The Office, led by Vivian Pinn, MD, has dedicated itself to advocating for more participation by women in all areas of medical research—as patients, trial subjects, and scientists.
Doctors’ Databank May Be Opened
Legislation being written in the U.S. House Commerce Committee may change the way in which the National Practitioner Data Bank is structured to allow public access to the information, according to an article in Modern Healthcare (August 28, 2000).
The databank contains information on disciplinary and peer actions against physicians and catalogues malpractice judgments against medical practitioners. The information, under a 1986 federal law, is available only to certain organizations—primarily hospitals and health maintenance organizations that use the data in their credentialing decisions. The information is not available to the public.
The proposed new law that would make the information public would allow doctors to write a 4000-word rebuttal or explanation of information in the file. The American Hospital Association and the American Medical Association have opposed any moves to make the information public. Patient advocacy groups such as the Public Citizen favor public access to the information.
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